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MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
SCH470001-00 Central Vermont Medical Center
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Covered Entity Details
Entity Name
Central Vermont Medical Center
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH470001-00
Entity Address
130 FISHER ROAD
BERLIN, VT 05602
Medicare Provider Number
470001
Participating Start Date
9/30/2010
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #81
80 FAIRGROUNDS PLZ
MORRISVILLE, VT 05661
Pharmacy Comments
Contract Details
Approval Date
7/13/2020
Contract Begin Date
7/21/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/25/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Matthew Choate, Vice President Patient Care Services / CNO
(802) 371-4354
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
7/13/2020
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